By Albert J. Bredenoord, André Smout, Jan Tack
This ebook describes the motives and medical administration of practical gastrointestinal issues in a without problems comprehensible manner, by using many transparent illustrations. The concrete and sensible suggestion supplied may be such a lot necessary within the medical perform of either the final practitioner and the scientific professional. useful problems of the gastrointestinal tract, similar to gastroesophageal reflux ailment, practical dyspepsia, and irritable bowel syndrome, are quite common and protracted stipulations. regardless of the new ebook of many clinical papers on their prognosis and therapy, a lot is still uncertain, and administration remains to be thought of difficult. This practice-oriented booklet might be an incredible resource of trustworthy updated assistance for all who take care of those patients.
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Additional info for A Guide to Gastrointestinal Motility Disorders
Absent contractility can be asymptomatic or can be associated with dysphagia. It is sometimes seen secondary to systemic sclerosis. There is no effective treatment for absent contractility. When concurrent reflux disease is present, this is treated medically as antireflux surgery is considered contraindicated in patients with absent peristalsis. 4 Minor Disorders of Peristalsis Ineffective esophageal motility and fragmented peristalsis are so-called minor disorders of peristalsis. Ineffective esophageal motility is characterized by a very low amplitude of the peristaltic contractions.
The serotonin-4 receptors, through which motilityenhancing drugs such as metoclopramide, cisapride, tegaserod, and prucalopride are acting, are an important target. They are expressed on nerve cells that generate and coordinate peristalsis and have been shown to enhance contractility from the esophagus to the colon and hence have seen application in gastroesophageal reflux disease, gastroparesis, and constipation. Dopamine receptors are another suitable target for stimulating motility. Dopamine-2 receptors are mainly expressed in the stomach and the proximal small bowel.
For symptoms occurring less frequently, histamine-2 blockers (such as ranitidine, famotidine, or cimetidine) can be used, which are less potent but have a more rapid onset of action. 2 Stool Softeners In case of constipation, a number of therapeutic agents act to soften consistency and increase volume of stool, based on two modes of action. , lactulose or lactitol) that undergo fermentation by colonic microbiota. This induces increased osmolality and attracts water to the stool which makes them softer and more voluminous.